{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T18:36:20Z","timestamp":1790620580901,"version":"4.1.0"},"reference-count":66,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,9]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The authors have provided a review of radiographic subsidence after lateral lumbar interbody fusion (LLIF) as a comparative analysis between titanium and polyetheretherketone (PEEK) cages. Many authors describe a reluctance to use titanium cages in spinal fusion secondary to subsidence concerns due to the increased modulus of elasticity of metal cages. The authors intend for this report to provide observational data regarding the juxtaposition of these two materials in the LLIF domain.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n A retrospective review of a prospectively maintained database identified 113 consecutive patients undergoing lateral fusion for degenerative indications from January to December 2017. The surgeons performing the cage implantations were two orthopedic spine surgeons and two neurosurgeons. Plain standing radiographs were obtained at 1\u20132 weeks, 8\u201312 weeks, and 12 months postoperatively. Using a validated grading system, interbody subsidence into the endplates was graded at these time points on a scale of 0 to III. The primary outcome measure was subsidence between the two groups. Secondary outcomes were analyzed as well.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Of the 113 patients in the sample, groups receiving PEEK and titanium implants were closely matched at 57 and 56 patients, respectively. Cumulatively, 156 cages were inserted and recombinant human bone morphogenetic protein\u20132 (rhBMP-2) was used in 38.1%. The average patient age was 60.4 years and average follow-up was 75.1 weeks. Subsidence in the titanium group in this study was less common than in the PEEK cage group. At early follow-up, groups had similar subsidence outcomes. Statistical significance was reached at the 8- to 12-week and 52-week follow-ups, demonstrating more subsidence in the PEEK cage group than the titanium cage group. rhBMP-2 usage was also highly correlated with higher subsidence rates at all 3 follow-up time points. Age was correlated with higher subsidence rates in univariate and multivariate analysis.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Titanium cages were associated with lower subsidence rates than PEEK cages in this investigation. Usage of rhBMP-2 was also robustly associated with higher endplate subsidence. Each additional year of age correlated with an increased subsidence risk. Subsidence in LLIF is likely a response to a myriad of factors that include but are certainly not limited to cage material. Hence, the avoidance of titanium interbody implants secondary solely to concerns over a modulus of elasticity likely overlooks other variables of equal or greater importance.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2020.6.focus20367","type":"journal-article","created":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T06:32:03Z","timestamp":1598941923000},"page":"E10","source":"Crossref","is-referenced-by-count":66,"title":["PEEK versus titanium cages in lateral lumbar interbody fusion: a comparative analysis of subsidence"],"prefix":"10.3171","volume":"49","author":[{"given":"Peter G.","family":"Campbell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Cavanaugh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierce","family":"Nunley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip A.","family":"Utter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eubulus","family":"Kerr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishi","family":"Wadhwa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Stone","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"suppl 3","key":"b1","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s00586-015-3886-1","article-title":"MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics","volume":"24","author":"Lehmen JA","year":"2015","unstructured":"Lehmen JA, Gerber EJ. MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics. Eur Spine J. 2015;24(suppl 3):287\u2013313.2585038710.1007\/s00586-015-3886-1"},{"issue":"1)(suppl)","key":"b2","series-title":"J Neurosurg","first-page":"60","article-title":"Visceral and vascular complications resulting from anterior lumbar interbody fusion","volume":"91","author":"Rajaraman V","year":"1999","unstructured":"Rajaraman V, Vingan R, Roth P, Visceral and vascular complications resulting from anterior lumbar interbody fusion. J Neurosurg. 1999;91(1)(suppl):60\u201364.10419370"},{"issue":"1","key":"b3","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3171\/2020.1.SPINE19776","article-title":"Impact of endplate-implant area mismatch on rates and grades of subsidence following stand-alone lateral lumbar interbody fusion: an analysis of 623 levels","volume":"33","author":"Agarwal N","year":"2020","unstructured":"Agarwal N, White MD, Zhang X, Impact of endplate-implant area mismatch on rates and grades of subsidence following stand-alone lateral lumbar interbody fusion: an analysis of 623 levels. J Neurosurg Spine. 2020;33(1):12\u201316.10.3171\/2020.1.SPINE19776"},{"issue":"6","key":"b4","series-title":"Int J Spine Surg","doi-asserted-by":"publisher","first-page":"575","DOI":"10.14444\/6080","article-title":"Randomized controlled trial of posterior lumbar interbody fusion with Ti- and CaP-nanocoated polyetheretherketone cages: comparative study of the 1-year radiological and clinical outcome","volume":"13","author":"Willems K","year":"2019","unstructured":"Willems K, Lauweryns P, Verleye G, VAN Goethem J. Randomized controlled trial of posterior lumbar interbody fusion with Ti- and CaP-nanocoated polyetheretherketone cages: comparative study of the 1-year radiological and clinical outcome. Int J Spine Surg. 2019;13(6):575\u2013587.10.14444\/608031970054"},{"issue":"14","key":"b5","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1097\/BRS.0b013e3182458b2f","article-title":"Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion","volume":"37","author":"Le TV","year":"2012","unstructured":"Le TV, Baaj AA, Dakwar E, Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion. Spine (Phila Pa 1976). 2012;37(14):1268\u20131273.10.1097\/BRS.0b013e3182458b2f"},{"key":"b6","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1016\/j.wneu.2017.05.035","article-title":"Elimination of subsidence with 26-mm-wide cages in extreme lateral interbody fusion","volume":"104","author":"Lang G","year":"2017","unstructured":"Lang G, Navarro-Ramirez R, Gandevia L, Elimination of subsidence with 26-mm-wide cages in extreme lateral interbody fusion. World Neurosurg. 2017;104:644\u2013652.2852664110.1016\/j.wneu.2017.05.035"},{"issue":"5","key":"b7","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1097\/BSD.0b013e3181af3a84","article-title":"Outcomes of interbody fusion cages used in 1 and 2-levels anterior cervical discectomy and fusion: titanium cages versus polyetheretherketone (PEEK) cages","volume":"23","author":"Niu CC","year":"2010","unstructured":"Niu CC, Liao JC, Chen WJ, Chen LH. Outcomes of interbody fusion cages used in 1 and 2-levels anterior cervical discectomy and fusion: titanium cages versus polyetheretherketone (PEEK) cages. J Spinal Disord Tech. 2010;23(5):310\u2013316.10.1097\/BSD.0b013e3181af3a8420124907"},{"issue":"3","key":"b8","series-title":"Biomaterials","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.biomaterials.2005.07.011","article-title":"Polyetheretherketone as a biomaterial for spinal applications","volume":"27","author":"Toth JM","year":"2006","unstructured":"Toth JM, Wang M, Estes BT, Polyetheretherketone as a biomaterial for spinal applications. Biomaterials. 2006;27(3):324\u2013334.10.1016\/j.biomaterials.2005.07.01116115677"},{"issue":"4","key":"b9","series-title":"Clin Spine Surg","doi-asserted-by":"publisher","first-page":"E208","DOI":"10.1097\/BSD.0b013e31826851a4","article-title":"PEEK versus Ti interbody fusion devices: resultant fusion, bone apposition, initial and 26-week biomechanics","volume":"29","author":"Pelletier MH","year":"2016","unstructured":"Pelletier MH, Cordaro N, Punjabi VM, PEEK versus Ti interbody fusion devices: resultant fusion, bone apposition, initial and 26-week biomechanics. Clin Spine Surg. 2016;29(4):E208\u2013E214.10.1097\/BSD.0b013e31826851a422801456"},{"key":"b10","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.jocn.2015.07.017","article-title":"PEEK-halo effect in interbody fusion","volume":"24","author":"Phan K","year":"2016","unstructured":"Phan K, Hogan JA, Assem Y, Mobbs RJ. PEEK-halo effect in interbody fusion. J Clin Neurosci. 2016;24:138\u2013140.2647450010.1016\/j.jocn.2015.07.017"},{"issue":"6","key":"b11","series-title":"J Oral Implantol","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1563\/aaid-joi-D-16-00072","article-title":"Bioactivity and osseointegration of PEEK are inferior to those of titanium: a systematic review","volume":"42","author":"Najeeb S","year":"2016","unstructured":"Najeeb S, Khurshid Z, Zohaib S, Zafar MS. Bioactivity and osseointegration of PEEK are inferior to those of titanium: a systematic review. J Oral Implantol. 2016;42(6):512\u2013516.2756016610.1563\/aaid-joi-D-16-00072"},{"issue":"3","key":"b12","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.spinee.2012.02.002","article-title":"Osteoblasts exhibit a more differentiated phenotype and increased bone morphogenetic protein production on titanium alloy substrates than on poly-ether-ether-ketone","volume":"12","author":"Olivares-Navarrete R","year":"2012","unstructured":"Olivares-Navarrete R, Gittens RA, Schneider JM, Osteoblasts exhibit a more differentiated phenotype and increased bone morphogenetic protein production on titanium alloy substrates than on poly-ether-ether-ketone. Spine J. 2012;12(3):265\u2013272.10.1016\/j.spinee.2012.02.00222424980"},{"issue":"1","key":"b13","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"110","DOI":"10.3171\/2013.4.SPINE12319","article-title":"Radiographic and clinical evaluation of cage subsidence after stand-alone lateral interbody fusion","volume":"19","author":"Marchi L","year":"2013","unstructured":"Marchi L, Abdala N, Oliveira L, Radiographic and clinical evaluation of cage subsidence after stand-alone lateral interbody fusion. J Neurosurg Spine. 2013;19(1):110\u2013118.2366289010.3171\/2013.4.SPINE12319"},{"issue":"5","key":"b14","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1097\/BRS.0000000000002822","article-title":"Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015","volume":"44","author":"Martin BI","year":"2019","unstructured":"Martin BI, Mirza SK, Spina N, Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015. Spine (Phila Pa 1976). 2019;44(5):369\u2013376.10.1097\/BRS.0000000000002822"},{"issue":"4","key":"b15","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1097\/01.bsd.0000211284.14143.63","article-title":"Circumferential arthrodesis using PEEK cages at the lumbar spine","volume":"20","author":"Rousseau MA","year":"2007","unstructured":"Rousseau MA, Lazennec JY, Saillant G. Circumferential arthrodesis using PEEK cages at the lumbar spine. J Spinal Disord Tech. 2007;20(4):278\u2013281.10.1097\/01.bsd.0000211284.14143.6317538351"},{"issue":"2","key":"b16","series-title":"J Spine Surg","doi-asserted-by":"publisher","first-page":"163","DOI":"10.21037\/jss.2017.05.01","article-title":"Elastic modulus in the selection of interbody implants","volume":"3","author":"Heary RF","year":"2017","unstructured":"Heary RF, Parvathreddy N, Sampath S, Agarwal N. Elastic modulus in the selection of interbody implants. J Spine Surg. 2017;3(2):163\u2013167.2874449610.21037\/jss.2017.05.01"},{"issue":"4","key":"b17","series-title":"Calcif Tissue Int","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1007\/s00223-018-0438-9","article-title":"Periprosthetic bone mineral density around uncemented titanium stems in the second and third decade after total hip arthroplasty: a DXA study after 12, 17 and 21 years","volume":"103","author":"Peitgen DS","year":"2018","unstructured":"Peitgen DS, Innmann MM, Merle C, Periprosthetic bone mineral density around uncemented titanium stems in the second and third decade after total hip arthroplasty: a DXA study after 12, 17 and 21 years. Calcif Tissue Int. 2018;103(4):372\u2013379.2985861510.1007\/s00223-018-0438-9"},{"issue":"11","key":"b18","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.1016\/j.spinee.2013.03.047","article-title":"Rough titanium alloys regulate osteoblast production of angiogenic factors","volume":"13","author":"Olivares-Navarrete R","year":"2013","unstructured":"Olivares-Navarrete R, Hyzy SL, Gittens RA, Rough titanium alloys regulate osteoblast production of angiogenic factors. Spine J. 2013;13(11):1563\u20131570.2368423810.1016\/j.spinee.2013.03.047"},{"issue":"2","key":"b19","series-title":"Orthop Surg","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1111\/os.12098","article-title":"Spine interbody implants: material selection and modification, functionalization and bioactivation of surfaces to improve osseointegration","volume":"6","author":"Rao PJ","year":"2014","unstructured":"Rao PJ, Pelletier MH, Walsh WR, Mobbs RJ. Spine interbody implants: material selection and modification, functionalization and bioactivation of surfaces to improve osseointegration. Orthop Surg. 2014;6(2):81\u201389.10.1111\/os.1209824890288"},{"issue":"7","key":"b20","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1016\/j.spinee.2020.03.008","article-title":"Porous titanium cervical interbody fusion device in the treatment of degenerative cervical radiculopathy; 1-year results of a prospective controlled trial","volume":"20","author":"Arts M","year":"2020","unstructured":"Arts M, Torensma B, Wolfs J. Porous titanium cervical interbody fusion device in the treatment of degenerative cervical radiculopathy; 1-year results of a prospective controlled trial. Spine J. 2020;20(7):1065\u20131072.10.1016\/j.spinee.2020.03.00832205276"},{"issue":"2","key":"b21","series-title":"J Biomed Mater Res A","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1002\/jbm.a.35926","article-title":"Enhancing the osteoblastic differentiation through nanoscale surface modifications","volume":"105","author":"Silva-Bermudez P","year":"2017","unstructured":"Silva-Bermudez P, Almaguer-Flores A, Garcia VI, Enhancing the osteoblastic differentiation through nanoscale surface modifications. J Biomed Mater Res A. 2017;105(2):498\u2013509.10.1002\/jbm.a.3592627706917"},{"issue":"1","key":"b22","series-title":"Neurospine","doi-asserted-by":"publisher","first-page":"125","DOI":"10.14245\/ns.2040058.029","article-title":"Polyetheretherketone versus titanium cages for posterior lumbar interbody fusion: meta-analysis and review of the literature","volume":"17","author":"Massaad E","year":"2020","unstructured":"Massaad E, Fatima N, Kiapour A, Polyetheretherketone versus titanium cages for posterior lumbar interbody fusion: meta-analysis and review of the literature. Neurospine. 2020;17(1):125\u2013135.3225216310.14245\/ns.2040058.029"},{"issue":"3","key":"b23","series-title":"Musculoskelet Surg","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/s12306-018-0580-6","article-title":"PEEK versus metal cages in posterior lumbar interbody fusion: a clinical and radiological comparative study","volume":"103","author":"Cuzzocrea F","year":"2019","unstructured":"Cuzzocrea F, Ivone A, Jannelli E, PEEK versus metal cages in posterior lumbar interbody fusion: a clinical and radiological comparative study. Musculoskelet Surg. 2019;103(3):237\u2013241.3053622310.1007\/s12306-018-0580-6"},{"issue":"10","key":"b24","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"2150","DOI":"10.1007\/s00586-014-3466-9","article-title":"Comparison of fusion rates following transforaminal lumbar interbody fusion using polyetheretherketone cages or titanium cages with transpedicular instrumentation","volume":"23","author":"Nemoto O","year":"2014","unstructured":"Nemoto O, Asazuma T, Yato Y, Comparison of fusion rates following transforaminal lumbar interbody fusion using polyetheretherketone cages or titanium cages with transpedicular instrumentation. Eur Spine J. 2014;23(10):2150\u20132155.10.1007\/s00586-014-3466-9"},{"issue":"10","key":"b25","series-title":"Bone Joint J","doi-asserted-by":"publisher","first-page":"1366","DOI":"10.1302\/0301-620X.99B10.BJJ-2016-1292.R2","article-title":"Transforaminal lumbar interbody fusion using polyetheretherketone oblique cages with and without a titanium coating: a randomised clinical pilot study","volume":"99-B","author":"Rickert M","year":"2017","unstructured":"Rickert M, Fleege C, Tarhan T, Transforaminal lumbar interbody fusion using polyetheretherketone oblique cages with and without a titanium coating: a randomised clinical pilot study. Bone Joint J. 2017;99-B(10):1366\u20131372.10.1302\/0301-620X.99B10.BJJ-2016-1292.R228963159"},{"issue":"2","key":"b26","series-title":"Asian Spine J","doi-asserted-by":"publisher","first-page":"248","DOI":"10.31616\/asj.2018.0169","article-title":"Early fusion status after posterior lumbar interbody fusion with cortical bone trajectory screw fixation: a comparison of titanium-coated polyetheretherketone cages and carbon polyetheretherketone cages","volume":"13","author":"Sakaura H","year":"2019","unstructured":"Sakaura H, Ohnishi A, Yamagishi A, Ohwada T. Early fusion status after posterior lumbar interbody fusion with cortical bone trajectory screw fixation: a comparison of titanium-coated polyetheretherketone cages and carbon polyetheretherketone cages. Asian Spine J. 2019;13(2):248\u2013253.10.31616\/asj.2018.016930481976"},{"issue":"6","key":"b27","series-title":"J Neurol Surg A Cent Eur Neurosurg","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1055\/s-0037-1604284","article-title":"Fusion rates of intervertebral polyetheretherketone and titanium cages without bone grafting in posterior interbody lumbar fusion surgery for degenerative lumbar instability","volume":"78","author":"Wrangel CV","year":"2017","unstructured":"Wrangel CV, Karakoyun A, Buchholz KM, Fusion rates of intervertebral polyetheretherketone and titanium cages without bone grafting in posterior interbody lumbar fusion surgery for degenerative lumbar instability. J Neurol Surg A Cent Eur Neurosurg. 2017;78(6):556\u2013560.10.1055\/s-0037-160428428800665"},{"issue":"7","key":"b28","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1007\/s00586-013-2772-y","article-title":"Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up","volume":"22","author":"Chen Y","year":"2013","unstructured":"Chen Y, Wang X, Lu X, Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up. Eur Spine J. 2013;22(7):1539\u20131546.2356825410.1007\/s00586-013-2772-y"},{"key":"b29","series-title":"BMC Musculoskelet Disord","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/1471-2474-13-172","article-title":"Anterior cervical discectomy and fusion: comparison of titanium and polyetheretherketone cages","volume":"13","author":"Cabraja M","year":"2012","unstructured":"Cabraja M, Oezdemir S, Koeppen D, Kroppenstedt S. Anterior cervical discectomy and fusion: comparison of titanium and polyetheretherketone cages. BMC Musculoskelet Disord. 2012;13:172.10.1186\/1471-2474-13-17222978810"},{"issue":"11","key":"b30","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1016\/j.jocn.2007.05.016","article-title":"Efficacy of anterior cervical fusion: comparison of titanium cages, polyetheretherketone (PEEK) cages and autogenous bone grafts","volume":"15","author":"Chou YC","year":"2008","unstructured":"Chou YC, Chen DC, Hsieh WA, Efficacy of anterior cervical fusion: comparison of titanium cages, polyetheretherketone (PEEK) cages and autogenous bone grafts. J Clin Neurosci. 2008;15(11):1240\u20131245.10.1016\/j.jocn.2007.05.01618801658"},{"key":"b31","series-title":"BMC Musculoskelet Disord","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1186\/s12891-016-1234-1","article-title":"Is PEEK cage better than titanium cage in anterior cervical discectomy and fusion surgery? A meta-analysis","volume":"17","author":"Li ZJ","year":"2016","unstructured":"Li ZJ, Wang Y, Xu GJ, Tian P. Is PEEK cage better than titanium cage in anterior cervical discectomy and fusion surgery? A meta-analysis. BMC Musculoskelet Disord. 2016;17:379.2758555310.1186\/s12891-016-1234-1"},{"issue":"3","key":"b32","series-title":"Orthop Traumatol Surg Res","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1016\/j.otsr.2017.11.018","article-title":"Incidence and impact of implant subsidence after stand-alone lateral lumbar interbody fusion","volume":"104","author":"Bocahut N","year":"2018","unstructured":"Bocahut N, Audureau E, Poignard A, Incidence and impact of implant subsidence after stand-alone lateral lumbar interbody fusion. Orthop Traumatol Surg Res. 2018;104(3):405\u2013410.2929212110.1016\/j.otsr.2017.11.018"},{"issue":"6","key":"b33","series-title":"Gland Surg","doi-asserted-by":"publisher","first-page":"715","DOI":"10.21037\/gs.2017.11.02","article-title":"A systematic review of intraoperative process mapping in surgery","volume":"6","author":"Chung RD","year":"2017","unstructured":"Chung RD, Hunter-Smith DJ, Spychal RT, A systematic review of intraoperative process mapping in surgery. Gland Surg. 2017;6(6):715\u2013725.10.21037\/gs.2017.11.02"},{"issue":"suppl 3","key":"b1","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"287","DOI":"10.1007\/s00586-015-3886-1","article-title":"MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics","volume":"24","author":"Lehmen JA","year":"2015","unstructured":"Lehmen JA, Gerber EJ. MIS lateral spine surgery: a systematic literature review of complications, outcomes, and economics. Eur Spine J. 2015;24(suppl 3):287\u2013313.2585038710.1007\/s00586-015-3886-1"},{"issue":"1)(suppl)","key":"b2","series-title":"J Neurosurg","first-page":"60","article-title":"Visceral and vascular complications resulting from anterior lumbar interbody fusion","volume":"91","author":"Rajaraman V","year":"1999","unstructured":"Rajaraman V, Vingan R, Roth P, Visceral and vascular complications resulting from anterior lumbar interbody fusion. J Neurosurg. 1999;91(1)(suppl):60\u201364.10419370"},{"issue":"1","key":"b3","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3171\/2020.1.SPINE19776","article-title":"Impact of endplate-implant area mismatch on rates and grades of subsidence following stand-alone lateral lumbar interbody fusion: an analysis of 623 levels","volume":"33","author":"Agarwal N","year":"2020","unstructured":"Agarwal N, White MD, Zhang X, Impact of endplate-implant area mismatch on rates and grades of subsidence following stand-alone lateral lumbar interbody fusion: an analysis of 623 levels. J Neurosurg Spine. 2020;33(1):12\u201316.10.3171\/2020.1.SPINE19776"},{"issue":"6","key":"b4","series-title":"Int J Spine Surg","doi-asserted-by":"publisher","first-page":"575","DOI":"10.14444\/6080","article-title":"Randomized controlled trial of posterior lumbar interbody fusion with Ti- and CaP-nanocoated polyetheretherketone cages: comparative study of the 1-year radiological and clinical outcome","volume":"13","author":"Willems K","year":"2019","unstructured":"Willems K, Lauweryns P, Verleye G, VAN Goethem J. Randomized controlled trial of posterior lumbar interbody fusion with Ti- and CaP-nanocoated polyetheretherketone cages: comparative study of the 1-year radiological and clinical outcome. Int J Spine Surg. 2019;13(6):575\u2013587.10.14444\/608031970054"},{"issue":"14","key":"b5","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"1268","DOI":"10.1097\/BRS.0b013e3182458b2f","article-title":"Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion","volume":"37","author":"Le TV","year":"2012","unstructured":"Le TV, Baaj AA, Dakwar E, Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion. Spine (Phila Pa 1976). 2012;37(14):1268\u20131273.10.1097\/BRS.0b013e3182458b2f"},{"key":"b6","series-title":"World Neurosurg","doi-asserted-by":"publisher","first-page":"644","DOI":"10.1016\/j.wneu.2017.05.035","article-title":"Elimination of subsidence with 26-mm-wide cages in extreme lateral interbody fusion","volume":"104","author":"Lang G","year":"2017","unstructured":"Lang G, Navarro-Ramirez R, Gandevia L, Elimination of subsidence with 26-mm-wide cages in extreme lateral interbody fusion. World Neurosurg. 2017;104:644\u2013652.2852664110.1016\/j.wneu.2017.05.035"},{"issue":"5","key":"b7","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"310","DOI":"10.1097\/BSD.0b013e3181af3a84","article-title":"Outcomes of interbody fusion cages used in 1 and 2-levels anterior cervical discectomy and fusion: titanium cages versus polyetheretherketone (PEEK) cages","volume":"23","author":"Niu CC","year":"2010","unstructured":"Niu CC, Liao JC, Chen WJ, Chen LH. Outcomes of interbody fusion cages used in 1 and 2-levels anterior cervical discectomy and fusion: titanium cages versus polyetheretherketone (PEEK) cages. J Spinal Disord Tech. 2010;23(5):310\u2013316.10.1097\/BSD.0b013e3181af3a8420124907"},{"issue":"3","key":"b8","series-title":"Biomaterials","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1016\/j.biomaterials.2005.07.011","article-title":"Polyetheretherketone as a biomaterial for spinal applications","volume":"27","author":"Toth JM","year":"2006","unstructured":"Toth JM, Wang M, Estes BT, Polyetheretherketone as a biomaterial for spinal applications. Biomaterials. 2006;27(3):324\u2013334.10.1016\/j.biomaterials.2005.07.01116115677"},{"issue":"4","key":"b9","series-title":"Clin Spine Surg","doi-asserted-by":"publisher","first-page":"E208","DOI":"10.1097\/BSD.0b013e31826851a4","article-title":"PEEK versus Ti interbody fusion devices: resultant fusion, bone apposition, initial and 26-week biomechanics","volume":"29","author":"Pelletier MH","year":"2016","unstructured":"Pelletier MH, Cordaro N, Punjabi VM, PEEK versus Ti interbody fusion devices: resultant fusion, bone apposition, initial and 26-week biomechanics. Clin Spine Surg. 2016;29(4):E208\u2013E214.10.1097\/BSD.0b013e31826851a422801456"},{"key":"b10","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"138","DOI":"10.1016\/j.jocn.2015.07.017","article-title":"PEEK-halo effect in interbody fusion","volume":"24","author":"Phan K","year":"2016","unstructured":"Phan K, Hogan JA, Assem Y, Mobbs RJ. PEEK-halo effect in interbody fusion. J Clin Neurosci. 2016;24:138\u2013140.2647450010.1016\/j.jocn.2015.07.017"},{"issue":"6","key":"b11","series-title":"J Oral Implantol","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1563\/aaid-joi-D-16-00072","article-title":"Bioactivity and osseointegration of PEEK are inferior to those of titanium: a systematic review","volume":"42","author":"Najeeb S","year":"2016","unstructured":"Najeeb S, Khurshid Z, Zohaib S, Zafar MS. Bioactivity and osseointegration of PEEK are inferior to those of titanium: a systematic review. J Oral Implantol. 2016;42(6):512\u2013516.2756016610.1563\/aaid-joi-D-16-00072"},{"issue":"3","key":"b12","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"265","DOI":"10.1016\/j.spinee.2012.02.002","article-title":"Osteoblasts exhibit a more differentiated phenotype and increased bone morphogenetic protein production on titanium alloy substrates than on poly-ether-ether-ketone","volume":"12","author":"Olivares-Navarrete R","year":"2012","unstructured":"Olivares-Navarrete R, Gittens RA, Schneider JM, Osteoblasts exhibit a more differentiated phenotype and increased bone morphogenetic protein production on titanium alloy substrates than on poly-ether-ether-ketone. Spine J. 2012;12(3):265\u2013272.10.1016\/j.spinee.2012.02.00222424980"},{"issue":"1","key":"b13","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"110","DOI":"10.3171\/2013.4.SPINE12319","article-title":"Radiographic and clinical evaluation of cage subsidence after stand-alone lateral interbody fusion","volume":"19","author":"Marchi L","year":"2013","unstructured":"Marchi L, Abdala N, Oliveira L, Radiographic and clinical evaluation of cage subsidence after stand-alone lateral interbody fusion. J Neurosurg Spine. 2013;19(1):110\u2013118.2366289010.3171\/2013.4.SPINE12319"},{"issue":"5","key":"b14","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1097\/BRS.0000000000002822","article-title":"Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015","volume":"44","author":"Martin BI","year":"2019","unstructured":"Martin BI, Mirza SK, Spina N, Trends in lumbar fusion procedure rates and associated hospital costs for degenerative spinal diseases in the United States, 2004 to 2015. Spine (Phila Pa 1976). 2019;44(5):369\u2013376.10.1097\/BRS.0000000000002822"},{"issue":"4","key":"b15","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1097\/01.bsd.0000211284.14143.63","article-title":"Circumferential arthrodesis using PEEK cages at the lumbar spine","volume":"20","author":"Rousseau MA","year":"2007","unstructured":"Rousseau MA, Lazennec JY, Saillant G. Circumferential arthrodesis using PEEK cages at the lumbar spine. J Spinal Disord Tech. 2007;20(4):278\u2013281.10.1097\/01.bsd.0000211284.14143.6317538351"},{"issue":"2","key":"b16","series-title":"J Spine Surg","doi-asserted-by":"publisher","first-page":"163","DOI":"10.21037\/jss.2017.05.01","article-title":"Elastic modulus in the selection of interbody implants","volume":"3","author":"Heary RF","year":"2017","unstructured":"Heary RF, Parvathreddy N, Sampath S, Agarwal N. Elastic modulus in the selection of interbody implants. J Spine Surg. 2017;3(2):163\u2013167.2874449610.21037\/jss.2017.05.01"},{"issue":"4","key":"b17","series-title":"Calcif Tissue Int","doi-asserted-by":"publisher","first-page":"372","DOI":"10.1007\/s00223-018-0438-9","article-title":"Periprosthetic bone mineral density around uncemented titanium stems in the second and third decade after total hip arthroplasty: a DXA study after 12, 17 and 21 years","volume":"103","author":"Peitgen DS","year":"2018","unstructured":"Peitgen DS, Innmann MM, Merle C, Periprosthetic bone mineral density around uncemented titanium stems in the second and third decade after total hip arthroplasty: a DXA study after 12, 17 and 21 years. Calcif Tissue Int. 2018;103(4):372\u2013379.2985861510.1007\/s00223-018-0438-9"},{"issue":"11","key":"b18","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.1016\/j.spinee.2013.03.047","article-title":"Rough titanium alloys regulate osteoblast production of angiogenic factors","volume":"13","author":"Olivares-Navarrete R","year":"2013","unstructured":"Olivares-Navarrete R, Hyzy SL, Gittens RA, Rough titanium alloys regulate osteoblast production of angiogenic factors. Spine J. 2013;13(11):1563\u20131570.2368423810.1016\/j.spinee.2013.03.047"},{"issue":"2","key":"b19","series-title":"Orthop Surg","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1111\/os.12098","article-title":"Spine interbody implants: material selection and modification, functionalization and bioactivation of surfaces to improve osseointegration","volume":"6","author":"Rao PJ","year":"2014","unstructured":"Rao PJ, Pelletier MH, Walsh WR, Mobbs RJ. Spine interbody implants: material selection and modification, functionalization and bioactivation of surfaces to improve osseointegration. Orthop Surg. 2014;6(2):81\u201389.10.1111\/os.1209824890288"},{"issue":"7","key":"b20","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"1065","DOI":"10.1016\/j.spinee.2020.03.008","article-title":"Porous titanium cervical interbody fusion device in the treatment of degenerative cervical radiculopathy; 1-year results of a prospective controlled trial","volume":"20","author":"Arts M","year":"2020","unstructured":"Arts M, Torensma B, Wolfs J. Porous titanium cervical interbody fusion device in the treatment of degenerative cervical radiculopathy; 1-year results of a prospective controlled trial. Spine J. 2020;20(7):1065\u20131072.10.1016\/j.spinee.2020.03.00832205276"},{"issue":"2","key":"b21","series-title":"J Biomed Mater Res A","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1002\/jbm.a.35926","article-title":"Enhancing the osteoblastic differentiation through nanoscale surface modifications","volume":"105","author":"Silva-Bermudez P","year":"2017","unstructured":"Silva-Bermudez P, Almaguer-Flores A, Garcia VI, Enhancing the osteoblastic differentiation through nanoscale surface modifications. J Biomed Mater Res A. 2017;105(2):498\u2013509.10.1002\/jbm.a.3592627706917"},{"issue":"1","key":"b22","series-title":"Neurospine","doi-asserted-by":"publisher","first-page":"125","DOI":"10.14245\/ns.2040058.029","article-title":"Polyetheretherketone versus titanium cages for posterior lumbar interbody fusion: meta-analysis and review of the literature","volume":"17","author":"Massaad E","year":"2020","unstructured":"Massaad E, Fatima N, Kiapour A, Polyetheretherketone versus titanium cages for posterior lumbar interbody fusion: meta-analysis and review of the literature. Neurospine. 2020;17(1):125\u2013135.3225216310.14245\/ns.2040058.029"},{"issue":"3","key":"b23","series-title":"Musculoskelet Surg","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/s12306-018-0580-6","article-title":"PEEK versus metal cages in posterior lumbar interbody fusion: a clinical and radiological comparative study","volume":"103","author":"Cuzzocrea F","year":"2019","unstructured":"Cuzzocrea F, Ivone A, Jannelli E, PEEK versus metal cages in posterior lumbar interbody fusion: a clinical and radiological comparative study. Musculoskelet Surg. 2019;103(3):237\u2013241.3053622310.1007\/s12306-018-0580-6"},{"issue":"10","key":"b24","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"2150","DOI":"10.1007\/s00586-014-3466-9","article-title":"Comparison of fusion rates following transforaminal lumbar interbody fusion using polyetheretherketone cages or titanium cages with transpedicular instrumentation","volume":"23","author":"Nemoto O","year":"2014","unstructured":"Nemoto O, Asazuma T, Yato Y, Comparison of fusion rates following transforaminal lumbar interbody fusion using polyetheretherketone cages or titanium cages with transpedicular instrumentation. Eur Spine J. 2014;23(10):2150\u20132155.10.1007\/s00586-014-3466-9"},{"issue":"10","key":"b25","series-title":"Bone Joint J","doi-asserted-by":"publisher","first-page":"1366","DOI":"10.1302\/0301-620X.99B10.BJJ-2016-1292.R2","article-title":"Transforaminal lumbar interbody fusion using polyetheretherketone oblique cages with and without a titanium coating: a randomised clinical pilot study","volume":"99-B","author":"Rickert M","year":"2017","unstructured":"Rickert M, Fleege C, Tarhan T, Transforaminal lumbar interbody fusion using polyetheretherketone oblique cages with and without a titanium coating: a randomised clinical pilot study. Bone Joint J. 2017;99-B(10):1366\u20131372.10.1302\/0301-620X.99B10.BJJ-2016-1292.R228963159"},{"issue":"2","key":"b26","series-title":"Asian Spine J","doi-asserted-by":"publisher","first-page":"248","DOI":"10.31616\/asj.2018.0169","article-title":"Early fusion status after posterior lumbar interbody fusion with cortical bone trajectory screw fixation: a comparison of titanium-coated polyetheretherketone cages and carbon polyetheretherketone cages","volume":"13","author":"Sakaura H","year":"2019","unstructured":"Sakaura H, Ohnishi A, Yamagishi A, Ohwada T. Early fusion status after posterior lumbar interbody fusion with cortical bone trajectory screw fixation: a comparison of titanium-coated polyetheretherketone cages and carbon polyetheretherketone cages. Asian Spine J. 2019;13(2):248\u2013253.10.31616\/asj.2018.016930481976"},{"issue":"6","key":"b27","series-title":"J Neurol Surg A Cent Eur Neurosurg","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1055\/s-0037-1604284","article-title":"Fusion rates of intervertebral polyetheretherketone and titanium cages without bone grafting in posterior interbody lumbar fusion surgery for degenerative lumbar instability","volume":"78","author":"Wrangel CV","year":"2017","unstructured":"Wrangel CV, Karakoyun A, Buchholz KM, Fusion rates of intervertebral polyetheretherketone and titanium cages without bone grafting in posterior interbody lumbar fusion surgery for degenerative lumbar instability. J Neurol Surg A Cent Eur Neurosurg. 2017;78(6):556\u2013560.10.1055\/s-0037-160428428800665"},{"issue":"7","key":"b28","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1539","DOI":"10.1007\/s00586-013-2772-y","article-title":"Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up","volume":"22","author":"Chen Y","year":"2013","unstructured":"Chen Y, Wang X, Lu X, Comparison of titanium and polyetheretherketone (PEEK) cages in the surgical treatment of multilevel cervical spondylotic myelopathy: a prospective, randomized, control study with over 7-year follow-up. Eur Spine J. 2013;22(7):1539\u20131546.2356825410.1007\/s00586-013-2772-y"},{"key":"b29","series-title":"BMC Musculoskelet Disord","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1186\/1471-2474-13-172","article-title":"Anterior cervical discectomy and fusion: comparison of titanium and polyetheretherketone cages","volume":"13","author":"Cabraja M","year":"2012","unstructured":"Cabraja M, Oezdemir S, Koeppen D, Kroppenstedt S. Anterior cervical discectomy and fusion: comparison of titanium and polyetheretherketone cages. BMC Musculoskelet Disord. 2012;13:172.10.1186\/1471-2474-13-17222978810"},{"issue":"11","key":"b30","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.1016\/j.jocn.2007.05.016","article-title":"Efficacy of anterior cervical fusion: comparison of titanium cages, polyetheretherketone (PEEK) cages and autogenous bone grafts","volume":"15","author":"Chou YC","year":"2008","unstructured":"Chou YC, Chen DC, Hsieh WA, Efficacy of anterior cervical fusion: comparison of titanium cages, polyetheretherketone (PEEK) cages and autogenous bone grafts. J Clin Neurosci. 2008;15(11):1240\u20131245.10.1016\/j.jocn.2007.05.01618801658"},{"key":"b31","series-title":"BMC Musculoskelet Disord","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1186\/s12891-016-1234-1","article-title":"Is PEEK cage better than titanium cage in anterior cervical discectomy and fusion surgery? A meta-analysis","volume":"17","author":"Li ZJ","year":"2016","unstructured":"Li ZJ, Wang Y, Xu GJ, Tian P. Is PEEK cage better than titanium cage in anterior cervical discectomy and fusion surgery? A meta-analysis. BMC Musculoskelet Disord. 2016;17:379.2758555310.1186\/s12891-016-1234-1"},{"issue":"3","key":"b32","series-title":"Orthop Traumatol Surg Res","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1016\/j.otsr.2017.11.018","article-title":"Incidence and impact of implant subsidence after stand-alone lateral lumbar interbody fusion","volume":"104","author":"Bocahut N","year":"2018","unstructured":"Bocahut N, Audureau E, Poignard A, Incidence and impact of implant subsidence after stand-alone lateral lumbar interbody fusion. Orthop Traumatol Surg Res. 2018;104(3):405\u2013410.2929212110.1016\/j.otsr.2017.11.018"},{"issue":"6","key":"b33","series-title":"Gland Surg","doi-asserted-by":"publisher","first-page":"715","DOI":"10.21037\/gs.2017.11.02","article-title":"A systematic review of intraoperative process mapping in surgery","volume":"6","author":"Chung RD","year":"2017","unstructured":"Chung RD, Hunter-Smith DJ, Spychal RT, A systematic review of intraoperative process mapping in surgery. Gland Surg. 2017;6(6):715\u2013725.10.21037\/gs.2017.11.02"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/49\/3\/article-pE10.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/49\/3\/article-pE10.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/49\/3\/article-pE10.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:35:08Z","timestamp":1780130108000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/49\/3\/article-pE10.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,9]]},"references-count":66,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2020.6.focus20367","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,9]]}}}